Reporting Special Incidents

For all vendors, a special incident is defined by Title 17, §54327 as:

· The consumer is missing and the vendor or long-term health care facility has filed a Missing Persons Report with a law enforcement agency;

· Reasonably suspected abuse/exploitation, including physical, sexual, fiduciary, emotional/mental, or physical and/or chemical restraint;

· Reasonably suspected neglect, including failure to provide medical care; failure to prevent malnutrition or dehydration; failure to protect from health and safety hazards; failure to assist in personal hygiene or the provision of food, clothing, or shelter; or failure to exercise the degree of care that a reasonable person would exercise in the position of having the care and custody of a dependent adult;

· Serious injury or accident, including lacerations requiring sutures or staples; puncture wounds requiring medical treatment beyond first aid; fractures; dislocations; bites that break the skin and require medical treatment beyond first aid; internal bleeding requiring treatment beyond first aid; any medication errors; medication reactions that require medical treatment beyond first aid; and burns that require medical treatment beyond first aid;

· Any unplanned or unscheduled hospitalization due to respiratory illness, seizure, cardiac-related, internal infection, diabetes, wound/skin care, nutritional deficiencies, or involuntary psychiatric admission;

· The death of any consumer, regardless of cause and regardless of when or where it occurred; and

· The victimization of a consumer defined as: robbery, aggravated assault, larceny, burglary, and rape/attempted rape, regardless of when or where such an incident occurred.

For Family Home Agencies, a special incident is defined by Title 17, §56093 as:

· All incidents as defined in §54327(b)

· Any occurrence or allegation of consumer abuse;

· Incidents which may result in criminal charges or legal action;

· Incidents which may result in the denial of a consumer’s rights;

· Poisonings;

· Catastrophes;

· Emergency treatment;

· Fires or explosions; and

· Any other incident which appears to have a negative affect on a consumer’s health, safety, or well-being.

The following is a listing of incidents which are not reported to DDS which should be reported to RCOC:

· Alleged violation of a consumer’s rights;

· Other sexual incident, including sexual harassment or inappropriate sexual contact;

· Aggressive acts to self, staff, family/visitors, or another consumer;

· Voluntary admission to a psychiatric hospital ;

· Behavioral crisis or episode, defined as a behavior which is atypical in that the behavior is new, or the intensity or frequency of the behavior is markedly increased;

· Use of restrictive behavior intervention;

· Emergency Room visit;

· Any unplanned hospitalization;

· Any injury or incident where medical treatment is required (i.e., physician, ER staff, paramedics, Physician's Assistant or nurse, etc.), or which otherwise appears to be significant;

· Alleged consumer abuse, neglect, or exploitation by a non-vendor, including physical, psychological, financial, neglect, or sexual abuse;

· Suicide threat or attempt;

· Unexplained pregnancy;

· Any incident which may result in criminal charges or legal action;

· Injury from a seizure, from another consumer, or from a behavior episode;

· Theft, or property damage;

· Diagnosis of communicable disease;

· Infestation by parasite/vector; and

· Unauthorized absence;

· The consumer is the alleged victim of a crime that is not one those listed in Section 54327.

When an incident occurs, notify RCOC of the incident by fax or telephone within 24 hours and submit a written report within 48 hours. The fax number for reporting is 714-796-0600. The telephone number for reporting is 714-796-5335. All incident reports should be submitted only to these numbers.

When notifying RCOC, include as much information as possible about the incident, including:

1. Please print or type incident reports. Reporters (the person calling or writing the report) should always include their name and phone number when making an incident report. Reports should always include a date written and the date/time/location of the incident. If the location of the incident is a specific vendor site, that should be noted.

2. Be sure that the consumer is accurately identified with name, date of birth, UCI number, sex, and diagnosis.

3. Be sure that the vendor name, address and phone number are included in the report.

4. Include the names and phone numbers of witnesses to the incident.

5. For hospitalizations or emergency room visits, include when consumer was seen/admitted, name of the physician who treated the consumer, what treatment was given, when the consumer was discharged, and what orders were given upon discharge.

6. For all incident reports, include follow-up activities such as appointments with the consumer’s primary physician, neurologist, psychiatrist, etc., Planning Team meetings, changes to Individual Service Plans/behavior plans, and whether consumer will need to be served by another vendor.

7. For 5150s, be prepared with information regarding the consumer’s past history of behaviors and psychiatric admissions, what behaviors led to the 5150, when consumer is expected to be discharged from the hospital, and whether the consumer will need to be served by another vendor.

8. If the consumer is a victim of a crime, abuse, or rights violation, include a description of the alleged perpetrator. This includes a general physical description, name, and relationship to consumer. If the alleged perpetrator is a staff person, the incident report should include information on the status of the vendor’s investigation. A final report of the investigation outcome should be submitted to RCOC upon completion of the investigation.

9. If the police were involved in the incident, include the name(s), badge number(s), police department, and phone number(s) of the responding police officer(s).

10. Include what action will be taken to prevent similar incidents from occurring in the future.

11. Include what other individuals/agencies were notified of the incident (parents, conservator, guardian, licensing agency, protective services agency, etc.). For agency contacts, include the name of the contact person and their phone number.

12. If the incident is expected to generate media interest, note this in the report.

13. When reporting deaths, it is especially important to report the following information:

ü What were the events leading up to death?

ü When was the consumer last in stable health?

ü What did the consumer do the day before he or she died?

ü Was the consumer's activity and appetite normal? If tube fed, were feedings being tolerated normally?

ü When was the last time the consumer was seen by a physician?

ü When was the last time the consumer was checked by a nurse?

ü When was the consumer last seen by a staff member before his or her death?

ü Was any type of intervention or resuscitation attempted? If so, what was done?

ü What is the presumed cause of death?